Comorbidities, Comedication and Drug-Drug Interactions in Patients With Hepatitis C and Addiction or Drug Abuse Treated With Direct-Acting Antivirals

Author: Juan Turnes Antonio García-Herola Ramón Morillo Marinela Mendez Cristina De Alvaro Candido Hernandez Antoni Sicras-Mainar

Theme: Clinical Research Year: 2022

< In previous studies we have analyzed drug-drug interactions (DDIs) in the general population. In
this sub-analysis we focus on patients with addiction to substance or drug abuse. The objective is to
describe the drug use, comorbidities, comedication, the associated risk of DDIs and the potential

< Retrospective observational study, obtained from the BIG-PAC database (Atrys Health), on HCV
patients (pts) treated between 2017 and 2020. Possible DDIs with direct-acting antivirals (DAAs)
(Sofosbuvir/Velpatasvir [SOF/VEL] and Glecaprevir/Pibrentasvir [GLE/PIB]) were evaluated using the
University of Liverpool Interactions for Hepatitis database. Potential outcome of DDIs: increase (↑)
in comedication concentration or ↑ DAA (possible impact on safety) and decrease in DAA, ↓DAA
(possible impact on efficacy).>

<985 pts with history or current consumption of abuse and recreational substances were included,
450 for SOF/VEL (mean age: 53 years; men 65%; F3/4 42%) and 535 with GLE/PIB (mean age: 50
years; men 65%, F3/4 30%). Regarding consumed substances there was higher consumption of
opioids in pts treated with SOF/VEL vs GLE/PIB (13% vs 9%, p <0.05, respectively).
The most prescribed drugs belonged to nervous system (40%); anti-infectives for systemic use,
(13%); cardiovascular (12%) and alimentary system (12%).
GLE/PIB presented a higher percentage of potential DDIs than SOF/VEL, with nervous system
medication (8.5% vs 4.9%, p <0.01) and cardiovascular (36.8% vs 13.7%, p <0.001); and similar for
alimentary system (45.4% vs 44.7%, ns) and anti-infectives (5.8% vs 6.9%, ns). The most prescribed
nervous system drugs with potential DDIs were quetiapine and metamizole.
9% (68) of pts with ≥2 comedications presented multiple DDIs (≥2 potential DDIs with DAAs): 30 pts
for SOF/VEL and 38 pts for GLE/PIB.>

< in Spain, 9% of HCV patients with addictions to abuse or recreational substances taking ≥2
comedications are at risk of multi-DDIs. >

Disclosure of Interest Statement:

See example below:
Speaking/consulting/research: JT (AbbVie, Gilead Sciences, MSD), AGH (AbbVie, Gilead Sciences), RM
(AbbVie, Gilead Sciences, Janssen, MSD, ViiV Healthcare), ASM (Atrys Health employee). Gilead
employees: MM, CdA and CH. This study was funded by Gilead Sciences.

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